Secondary immunodeficiency with infectious complications following immunosuppressive therapy in a female patient with systemic lupus erythematosus
Abstract
We present a young female with systemic lupus erythematosus with cutaneous vasculitis, necrotic defects and suspected vasculitis of colon. The glucocorticoid therapy and the administration of pulse intravenous cyclophosphamide led to a decrease in IgG and IgA levels with numerous infectious complications, e.g.
Salmonella gonitis, thrush, vaginal mycosis with labial phlegmon and herpetic efflorescence in gluteal area, cultured Staphylococcus aureus from the vasculitic defect on an elbow. The administration of a substitution dose of intravenous immunoglobulins (IVIG), targeted antibiotic, virostatic and antimycotic therapy led to improvement in clinical and laboratory findings.
A new onset of diabetes mellitus, presumably induced by glucocorticoids, has been documented.